Healthcare Provider Details

I. General information

NPI: 1851409262
Provider Name (Legal Business Name): MARGARITA PEREZ L.M.F.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2006
Last Update Date: 12/01/2023
Certification Date: 12/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4084 BRIDGE ST STE 1
FAIR OAKS CA
95628-7171
US

IV. Provider business mailing address

6041 HOLETON RD
CARMICHAEL CA
95608-3324
US

V. Phone/Fax

Practice location:
  • Phone: 916-768-0259
  • Fax:
Mailing address:
  • Phone: 323-440-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC18000
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: